Compressive distal humerus plating system

ABSTRACT

A system for compressing a fracture can include a first bone plate having a first proximal end and a first distal end, and a second bone plate having a second proximal end and a second distal end. The second bone plate can be spaced apart from the first bone plate. The system can include an expansion member coupled to the second proximal end of the second bone plate. The movement of the expansion member relative to the second bone plate can cause the first distal end of the first bone plate and the second distal end of the second bone plate to move toward each other to compress the fracture.

CROSS-REFERENCE TO RELATED APPLICATIONS

This application claims the benefit of U.S. Provisional Application No.61/548,444, filed on Oct. 18, 2011. The entire disclosure of the aboveapplication is incorporated herein by reference.

INTRODUCTION

In general, the human musculoskeletal system is composed of a variety oftissues including bone, ligaments, cartilage, muscle, and tendons.Tissue damage or deformity stemming from trauma, pathologicaldegeneration, or congenital conditions often necessitates surgicalintervention to restore function or repair the damaged tissue. Surgicalintervention can include any surgical procedure that can restorefunction to the damaged tissue, which can require the use of one or moreorthopedic prosthesis, such as orthopedic nails, screws, implants,plates, etc., to restore function to the damaged tissue.

The present teachings relate to a plating system for use in restoringfunction to damaged tissue, and more specifically relates to acompressive distal humerus plating system.

SUMMARY

According to various aspects, provided is a system for compressing afracture. The system can include a first bone plate having a firstproximal end and a first distal end, and a second bone plate having asecond proximal end and a second distal end. The second bone plate canbe spaced apart from the first bone plate. The system can include anexpansion member coupled to the second proximal end of the second boneplate. The movement of the expansion member relative to the second boneplate can cause the first distal end of the first bone plate and thesecond distal end of the second bone plate to move toward each other tocompress the fracture.

Further provided is a system for compressing a fracture. The system caninclude a first bone plate having a first proximal end and a firstdistal end, and a second bone plate having a second proximal end and asecond distal end. The system can include a first bone fastener coupledto one of the first bone plate and the second bone plate. The first bonefastener can have a bore transverse to an axis of the first bonefastener. The system can include a second bone fastener coupled to theother of the first bone plate and the second bone plate such that thesecond bone fastener passes through the bore of the first bone fastener.

Additionally, provided is a system for compressing a fracture. Thesystem can include a first bone plate having a first proximal end and afirst distal end. The system can also include a second bone plate havinga second proximal end and a second distal end. The system can include afirst bone fastener coupled to the first proximal end of the first boneplate and the second distal end of the second bone plate. The system caninclude a second bone fastener coupled to the first distal end of thefirst bone plate and the second proximal end of the second bone plate.

Further areas of applicability will become apparent from the descriptionprovided herein. It should be understood that the description andspecific examples are intended for purposes of illustration only and arenot intended to limit the scope of the present teachings.

DRAWINGS

The drawings described herein are for illustration purposes only and arenot intended to limit the scope of the present teachings in any way.

FIG. 1 is a schematic front view of an exemplary compressive distalhumerus plating system according to the present teachings shownoperatively associated with a distal humerus;

FIG. 2 is a partial cross-sectional view of the plating system of FIG.1;

FIG. 3 is a schematic front view of another exemplary compressive distalhumerus plating system for use with a distal humerus according to thepresent teachings;

FIG. 4 is a partial cross-sectional view of the plating system of FIG.3;

FIG. 5 is a schematic perspective illustration of another exemplarycompressive distal humerus plating system for use with a distal humerusaccording to the present teachings;

FIG. 6 is a schematic perspective illustration of another exemplarycompressive distal humerus plating system for use with a distal humerusaccording to the present teachings;

FIG. 7 is a perspective view of a compression system for use with thecompressive distal humerus plating system of FIG. 6;

FIG. 8 is a schematic front view of another exemplary compressive distalhumerus plating system for use with a distal humerus according to thepresent teachings;

FIG. 9 is a schematic front view of another exemplary compressive distalhumerus plating system for use with a distal humerus according to thepresent teachings;

FIG. 10 is a schematic front view of an exemplary compressive distalhumerus plating system for use with a distal humerus according to thepresent teachings; and

FIG. 11 is a partial cross-sectional view of the plating system of FIG.10.

DESCRIPTION OF VARIOUS ASPECTS

The following description is merely exemplary in nature and is notintended to limit the present teachings, application, or uses. It shouldbe understood that throughout the drawings, corresponding referencenumerals indicate like or corresponding parts and features. Although thefollowing description is related generally to a plating system for usein an anatomy to restore function to damaged tissue, such as in the caseof a distal humerus, it will be understood that the teachings of thesystem as described and claimed herein can be used in any appropriatesurgical procedure. For example, the plating system described andclaimed herein can be used to repair any suitable bone fracture, such asa fracture of a femur, and can be used at any location along thefractured anatomy, such as a distal end, proximal end, etc. Therefore,it will be understood that the following discussions are not intended tolimit the scope of the present teachings and claims herein.

With reference to FIGS. 1 and 2, a compressive plating system 10 isshown. The compressive plating system 10 may be particularly adapted fora compressing a fracture of a distal humerus H. Various aspects of thepresent teachings, however, may have application for other procedures,such as to repair a pediatric femoral fracture and other fractures. Oneexample is shown in FIGS. 1 and 2. The compressive plating system 10 caninclude a first plate 12, a second plate 14 and a compression system 16.In one example, the first plate 12 can be positioned substantiallyopposite or about 180 degrees apart from the second plate 14 about thedistal humerus H. It should be noted, however, that the first plate 12and the second plate 14 could be positioned about 90 degrees apart fromeach on the distal humerus H to compress a fracture of the distalhumerus H using the compression system 16, if desired.

With reference to FIG. 1, the first plate 12 can have a proximal end 18,a distal end 20, a first side 22 and a second side 24. The first plate12 can be composed of a suitable biocompatible material, such as abiocompatible metal or polymer. For example, the first plate 12 could becomposed of titanium or stainless steel. The first plate 12 can includeat least one or a plurality of throughbores 26, which can extend throughthe first side 22 and the second side 24 between the proximal end 18 andthe distal end 20. The throughbores 26 can enable the receipt of one ormore fasteners, such as a bone fastener, to couple the first plate 12 tothe anatomy.

In one example, one or more of the throughbores 26 can include at leasta portion that is generally spherical in shape, and can include aplurality of threads 26 a defined about each spherically shapedthroughbore 26. The plurality of threads 26 a can mate with a pluralityof threads formed on a head of the bone fastener to enable the bonefastener to be locked to the first plate 12. It should be noted that thehead of the bone fasteners need not include a plurality of threads. Inthis regard, a bone fastener having an unthreaded head can seat in thethroughbore 26. Further, one or more of the throughbores 26 could bedevoid of the plurality of threads 26 a, if desired. It should also benoted that the placement of the plurality of throughbores 26 is merelyexemplary, as the throughbores 26 could be defined at any desiredlocation along the first plate 12.

The proximal end 18 of the first plate 12 can include a recess 28 and apivot bore 30. The recess 28 can be formed on the second side 24. In oneexample, the recess 28 can be formed on the second side 24 so as to notextend through the first plate 12 to the first side 22. The recess 28can receive a portion of the compression system 16, as will be discussedin greater detail herein.

The pivot bore 30 can be defined through the proximal end 18 of thefirst plate 12 from the first side 22 to the second side 24. The pivotbore 30 can be substantially spherical in shape, and can include atleast one or a plurality of threads 30 a. The plurality of threads 30 acan cooperate with a portion of the compression system 16 to couple aportion of the compression system 16 to the first plate 12.

The distal end 20 can be curved and shaped to conform to the distalhumerus H. The distal end 20 can include a leading portion 32 and acurved portion 34. The leading portion 32 can transition the proximalend 18 to the curved portion 34. The curved portion 34 can be shaped tofit around a medial epicondyle 38 of the distal humerus H, for example.The shape of the distal end 20 can cooperate with the compression system16 to enable the first plate 12 to compress the distal humerus H.

The first side 22 of the first plate 12 can be opposite the second side24. The first side 22 can be substantially smooth. The second side 24can be positioned adjacent to the distal humerus H when the first plate12 is coupled to the distal humerus H. If desired, the second side 24can be contoured to match the shape of the distal humerus H.

With continued reference to FIG. 1, as the second plate 14 can besimilar to the first plate 12, only the differences between the firstplate 12 and the second plate 14 will be discussed in great detailherein, and the same reference numerals will be used to denote the sameor similar components. The second plate 14 can have a proximal end 42, adistal end 44, the first side 22 and the second side 24. The secondplate 14 can be composed of a suitable biocompatible material, such as abiocompatible metal or polymer. For example, the second plate 14 couldbe composed of titanium or stainless steel. The second plate 14 caninclude the plurality of throughbores 26, which can enable the receiptof one or more fasteners, such as a bone fastener, to couple the secondplate 14 to the anatomy.

The proximal end 42 of the second plate 14 can include a first bore 46and the pivot bore 30. The pivot bore 30 of the second plate 14 can besubstantially coaxially aligned with the pivot bore 30 of the firstplate 12 to enable receipt of a portion of the compression system 16therethrough. The first bore 46 can be coaxially aligned with the recess28 of the first plate 12 to enable receipt of a portion of thecompression system 16 therethrough. The first bore 46 can be formedthrough the first side 22 to the second side 24. The first bore 46 caninclude at least one or a plurality of threads 46 a. The plurality ofthreads 46 a can threadably engage a portion of the compression system16, as will be discussed herein.

The distal end 20 can be curved and shaped to conform to the distalhumerus H. The distal end 20 can include the leading portion 32 and acurved portion 48. The curved portion 48 can be shaped to fit around alateral epicondyle 50 of the distal humerus H. The shape of the distalend 20 can cooperate with the compression system 16 to enable the secondplate 14 to compress the distal humerus H.

With reference to FIGS. 1 and 2, the compression system 16 can cooperatewith the first plate 12 and the second plate 14 to compress the fractureof the distal humerus H. The compression system 16 can include a pivotdevice 52 and an expansion member or compression device 54. The pivotdevice 52 can cooperate with the first plate 12 and the second plate 14to enable the first plate 12 and the second plate 14 to pivot to assistin compression. The pivot device 52 can include a first pivot member 56,a second pivot member 58 and at least one screw head cap 60. The firstpivot member 56 and the second pivot member 58 can be received within afirst bore B1 formed through the distal humerus H.

The first pivot member 56 can include a head 62 and a shank 64. The head62 can be substantially spherical for receipt in the pivot bore 30 ofthe first plate 12. The head 62 can be generally smooth. The head 62 caninclude a driver engagement feature 62 a, which can enable a suitabletool to be used to couple the first pivot member 56 into the secondpivot member 58, as will be discussed herein. The shank 64 can extendfrom the head 62. The shank 64 can include a plurality of threads 64 a.The plurality of threads 64 a can threadably engage the second pivotmember 58.

As the second pivot member 58 can be similar to the first pivot member56, only the differences between the first pivot member 56 and thesecond pivot member 58 will be discussed in great detail herein, and thesame reference numerals will be used to denote the same or similarcomponents. The second pivot member 58 can include the head 62 and ashank 66. The head 62 can be received in the pivot bore 30 of the secondplate 14. The shank 66 can extend from the head 62. The shank 66 caninclude a counterbored aperture 68. The counterbored aperture 68 caninclude a plurality of threads 68 a. The plurality of threads 68 a canthreadably engage the plurality of threads 64 a of the first pivotmember 56 to threadably couple the first pivot member 56 to the secondpivot member 58.

As best shown in FIG. 2, the screw head cap 60 can be substantiallycircular in shape, and can include a bore 70 and a plurality of threads72. The screw head cap 60 can be received over the head 62 of the firstpivot member 56 and the second pivot member 58 to retain the first pivotmember 56 and the second pivot member 58 within the pivot bore 30. Thebore 70 can be defined from a first surface 60 a to a second surface 60b. The bore 70 can have a spherical taper 70 a, which can be shaped tomate with the spherical head 62. The plurality of threads 72 can extendalong a circumference of the screw head cap 60 from the first surface 60a to the second surface 60 b. The plurality of threads 72 can engage theplurality of threads 30 a of the pivot bore 30 to retain the first pivotmember 56 and the second pivot member 58 within the pivot bore 30.

The compression device 54 can be received through a second bore B2formed in the distal humerus H. The compression device 54 can becomposed of a suitable biocompatible material, such as a biocompatiblemetal. In one example, the compression device 54 can comprise a pin. Thecompression device 54 can include a first end 74 and a second end 76.The first end 74 can include a plurality of threads 74 a and a driverengagement feature 74 b. The plurality of threads 74 a can threadablyengage the plurality of threads 46 a of the first bore 46 to enable thecompression device 54 to be threadably advanced through the second boreB2. The second end 76 can be rounded and smooth for receipt in therecess 28. The compression device 54 can be received through the firstbore 46 such that the plurality of threads 74 a can engage the pluralityof threads 46 a of the first bore 46 to advance the compression device54 within the first bore 46. Advancement of the compression device 54can push against the proximal end 18 of the first plate 12. Withreference to FIG. 1, this application of force between the first plate12 and the second plate 14 can cause the distal end 20 of the firstplate 12 to move toward the distal humerus H, thereby compressing thefracture of the distal humerus H.

In order to couple the compressive plating system 10 to an anatomy, suchas the distal humerus H, an incision can be made adjacent to the distalhumerus H. In one exemplary method, with reference to FIG. 1, the firstplate 12 can be positioned adjacent to the distal humerus, such that thecurved portion 34 is adjacent to the medial epicondyle 38. One or morebone fasteners can be inserted through the one or more throughbores 26of the first plate 12 to couple the first plate 12 to the anatomy. Thesecond plate 14 can be positioned opposite the first plate 12 such thatthe curved portion 48 is adjacent to the lateral epicondyle 50. One ormore bone fasteners can be inserted through the one or more throughbores26 of the second plate 14 to couple the second plate 14 to the anatomy.With or without the use of a guide wire, a first bore B1 can be formedthrough the distal humerus H, using the pivot bores 30 of the firstplate 12 and the second plate 14 as guides.

Then, the first pivot member 56 and the second pivot member 58 can beinserted into the first bore B1 so that the head 62 of the first pivotmember 56 and the head 62 of the second pivot member 58 rest within thepivot bores 30. The first pivot member 56 can be threaded intoengagement with the second pivot member 58 via a tool engaged with atleast one of the driver engagement features 62 a of the head 62 of thefirst pivot member 56 and the head 62 of the second pivot member 58.Then, screw head caps 60 can be threadably coupled to the pivot bores 30to rotatably retain the first pivot member 56 and the second pivotmember 58 within the first bore B1.

With or without the use of a guide wire, with reference to FIG. 2, thesecond bore B1 can be drilled through the distal humerus H from thefirst bore 46 to the recess 28. Then, the compression device 54 can beinserted through the first bore 46, and the plurality of threads 72 ofthe compression device 54 can threadably engage the plurality of threads46 a of the first bore 46. Threaded advancement of the compressiondevice 54 within the first bore 46 can cause the second end 76 of thecompression device 54 to contact the recess 28. The continuedadvancement of the compression device 54 can cause the proximal end 18of the first plate 12 and the second plate 14 to move outwardly, asillustrated in FIG. 1. The pivot device 52 constrains the movement ofthe first plate 12 and the second plate 14, thus, the force against theproximal end 18 of the first plate 12 and the proximal end 42 of thesecond plate 14 causes the distal end 20 of the first plate 12 to movetoward the distal end 44 of the second plate 14 to compress a fracturein the distal humerus H.

With reference now to FIGS. 3 and 4, in one example, a compressiveplating system 100 can be employed to repair a damaged portion of ananatomy. As the compressive plating system 100 can be similar to thecompressive plating system 10 described with reference to FIGS. 1 and 2,only the differences between the compressive plating system 10 and thecompressive plating system 100 will be discussed in great detail herein,and the same reference numerals will be used to denote the same orsimilar components. With reference to FIGS. 3 and 4, the compressiveplating system 100 can include a first plate 102, a second plate 104 anda compression system 106. In one example, the first plate 102 can bepositioned opposite or about 180 degrees apart from the second plate 104about the distal humerus H.

With reference to FIG. 3, the first plate 102 can have a proximal end108, a distal end 110, a first side 112 and a second side 114. The firstplate 102 can be composed of a suitable biocompatible material, such asa biocompatible metal or polymer. For example, the first plate 102 couldbe composed of titanium or stainless steel. The first plate 102 caninclude the plurality of throughbores 26, which can extend through thefirst side 112 and the second side 114 between the proximal end 108 andthe distal end 110. As discussed, the throughbores 26 can each receive abone fastener to couple the first plate 102 to the distal humerus H.

The distal end 110 can be curved and shaped to conform to the distalhumerus H. The distal end 110 can include a leading portion 116 and acurved portion 118. The leading portion 116 can transition the proximalend 108 to the curved portion 118. The curved portion 118 can be shapedto fit around the medial epicondyle 38 of the distal humerus H. Thecurved portion 118 can include a bore 120. The bore 120 can besubstantially spherical, and can taper to an aperture 120 a. Theaperture 120 a can enable the receipt of a portion of the compressionsystem 106 to be positioned therethrough. In one example, the bore 120can taper to an elongated slot, which can enable a portion of thecompression system 106 to be positioned at any desired angle relative tothe first plate 102. Alternatively, the bore 120 can taper to a circularaperture.

The first side 112 of the first plate 102 can be opposite the secondside 114. The first side 112 can be substantially smooth. The secondside 114 can be positioned adjacent to the distal humerus H when thefirst plate 102 is coupled to the distal humerus H. If desired, thesecond side 114 can be contoured to match the shape of the distalhumerus H.

As the second plate 104 can be similar to the first plate 102, only thedifferences between the first plate 102 and the second plate 104 will bediscussed in great detail herein, and the same reference numerals willbe used to denote the same or similar components. The second plate 104can have the proximal end 108, a distal end 122, the first side 112 andthe second side 114. The second plate 104 can be composed of a suitablebiocompatible material, such as a biocompatible metal or polymer. Forexample, the second plate 104 could be composed of titanium or stainlesssteel. The second plate 104 can include the plurality of throughbores26, which can extend through the first side 112 and the second side 114between the proximal end 108 and the distal end 122. As discussed, thethroughbores 26 can each receive a bone fastener to couple the secondplate 104 to the distal humerus H.

The distal end 122 can be curved and shaped to conform to the distalhumerus H. The distal end 122 can include the leading portion 116 and acurved portion 124. The curved portion 124 can be shaped to fit aroundthe lateral epicondyle 50 of the distal humerus H. The curved portion124 can include the bore 120.

The compression system 106 can cooperate with the first plate 102 andthe second plate 104 to compress a distal humerus fracture. Thecompression system 106 can include a first member 126 and a secondmember 128. The first member 126 can have a head 130 and a shank 132.The head 130 can be substantially spherical to mate with the bore 120.It should be noted, however, that although the compression system 106 isdescribed and illustrated herein as being received through the bores120, the compression system 106 could also be received through anyopposed throughbores 26. The head 130 can include a driver engagementfeature 130 a, for receipt of a suitable instrument to drive the firstmember 126 into engagement with the second member 128, as will bediscussed herein. The head 130 can be generally smooth. It should benoted that the head 130 could include a plurality of threads for matingwith a plurality of threads formed in the bore 120, if desired. Theshank 132 can extend from the head 130. The shank 132 can include aplurality of threads 132 a. The plurality of threads 132 a canthreadably engage the second member 128.

As the second member 128 can be similar to the first member 126, onlythe differences between the first member 126 and the second member 128will be discussed in great detail herein, and the same referencenumerals will be used to denote the same or similar components. Thesecond member 128 can include the head 130 and a shank 134. The head 130can be received in the bore 120 of the second plate 104. The shank 134can extend from the head 130. The shank 134 can include a counterboredaperture 136. The counterbored aperture 136 can include a plurality ofthreads 136 a. The plurality of threads 136 a can threadably engage theplurality of threads 132 a of the first member 126 to threadably couplethe first member 126 to the second member 128.

In order to couple the compressive plating system 100 to an anatomy,such as the distal humerus H, an incision can be made adjacent to thedistal humerus H. In one exemplary method, with reference to FIG. 3, thefirst plate 102 can be positioned adjacent to the distal humerus H, suchthat the curved portion 118 is adjacent to the medial epicondyle 38. Oneor more bone fasteners can be inserted through the one or morethroughbores 26 of the first plate 102 to couple the first plate 102 tothe anatomy. The second plate 104 can be positioned opposite the firstplate 102 such that the curved portion 124 is adjacent to the lateralepicondyle 50. One or more bone fasteners can be inserted through theone or more throughbores 26 of the second plate 104 to couple the secondplate 104 to the anatomy.

In one example, a guide wire can be positioned between the bore 120 ofthe first plate 102 and the bore 120 of the second plate 104. If eitheror both of the bores 120 taper to a slot, then the guide wire can beorientated at any desired angle to form a bore B3 through the distalhumerus H. Then, a drill bit can be passed over the guide wire to formthe bore B3 in the anatomy. The first member 126 and the second member128 can be inserted into a respective one of the bore 120 of the firstplate 102 and the bore 120 of the second plate 104. Then, a suitabletool can be engaged with the driver engagement features 130 a tothreadably engage the first member 126 with the second member 128. Thecontinued advancement of the first member 126 within the second member128 can compress a fracture at the distal humerus H.

Alternatively, with reference to FIG. 5, in one example, a compressiveplating system 150 can be employed to repair a damaged portion of ananatomy. As the compressive plating system 150 can be similar to thecompressive plating system 100 described with reference to FIGS. 3 and4, only the differences between the compressive plating system 100 andthe compressive plating system 150 will be discussed in great detailherein, and the same reference numerals will be used to denote the sameor similar components. With reference to FIG. 5, the compressive platingsystem 150 can include the first plate 102, a second plate 154 and thecompression system 106. In one example, the first plate 102 can bepositioned about 90 degrees apart from the second plate 154 about thedistal humerus H, and the compression system 106 can be used to compressa fracture of the distal humerus H. A plurality of bone fasteners 152can also be inserted through the throughbores 26 of the first plate 102and the second plate 154 to couple the first plate 102 and the secondplate 154 to the anatomy.

The second plate 154 can have a proximal end 158, the distal end 160,the first side 112 and the second side 114. The proximal end 158 of thesecond plate 154 can have a longer length than the proximal end 108 ofthe first plate 102. It should be noted that the proximal end 158 of thesecond plate 154 could have the same length as the proximal end 108 ofthe first plate 102, or the proximal end 108 of the first plate 102could have a length longer than the proximal end 158 of the second plate154.

The distal end 160 can be curved and shaped to conform to the distalhumerus H. The distal end 160 can include the leading portion 116, thecurved portion 124 and a flange 162. The flange 162 can extend outwardlyfrom the curved portion 124 of the distal end 160 of the second plate154. The flange 162 can be curved, and can include the bore 120. Itshould be noted that the flange 162 can have any desired shape and canextend outwardly at any desired location along the length of the secondplate 154. In addition, the second plate 154 need not include the flange162, as the bore 120 can be formed through the distal end 160 of thesecond plate 154.

In this example, the first member 126 can be inserted through the bore120 of the flange 162 of the second plate 154, and the second member 128can be inserted through the bore 120 of the first plate 102. Thus, thecompression system 106 can be used to compress a fracture of the distalhumerus H when the first plate 102 and the second plate 154 are about 90degrees offset from each other about the distal humerus H.

With reference now to FIGS. 6 and 7, in one example, a compressiveplating system 200 can be employed to repair a damaged portion of ananatomy. As the compressive plating system 200 can be similar to thecompressive plating system 150 described with reference to FIG. 5, onlythe differences between the compressive plating system 150 and thecompressive plating system 200 will be discussed in great detail herein,and the same reference numerals will be used to denote the same orsimilar components. With reference to FIG. 6, the compressive platingsystem 200 can include a first plate 202, a second plate 204 and acompression system 206. In one example, the first plate 202 can bepositioned about 90 degrees apart from the second plate 204 about thedistal humerus H.

The first plate 202 can have the proximal end 108, a distal end 210, thefirst side 112 and the second side 114. The first plate 202 can becomposed of a suitable biocompatible material, such as a biocompatiblemetal or polymer. For example, the first plate 202 could be composed oftitanium or stainless steel. The first plate 202 can include theplurality of throughbores 26, which can extend through the first side112 and the second side 114 between the proximal end 108 and the distalend 210. The plurality of bone fasteners 152 can also be insertedthrough the throughbores 26 of the first plate 102 to couple the firstplate 102 to the anatomy.

The distal end 210 can be curved and shaped to conform to the distalhumerus H. The distal end 210 can include the leading portion 116 and acurved portion 218. The curved portion 218 can be shaped to fit aroundthe medial epicondyle 38 of the distal humerus H. The curved portion 218can include a bore 220. The bore 220 can be substantially spherical, andcan include a plurality of threads 220 a. The bore 220 can enable aportion of the compression system 206 to be positioned therethrough.

As the second plate 204 can be similar to the first plate 202, only thedifferences between the first plate 202 and the second plate 204 will bediscussed in great detail herein, and the same reference numerals willbe used to denote the same or similar components. With reference to FIG.6, the second plate 204 can have the proximal end 158, a distal end 222,the first side 112 and the second side 114. The second plate 204 can becomposed of a suitable biocompatible material, such as a biocompatiblemetal or polymer. For example, the second plate 204 could be composed oftitanium or stainless steel. The second plate 204 can include theplurality of throughbores 26, which can extend through the first side112 and the second side 114 between the proximal end 158 and the distalend 222. The plurality of bone fasteners 152 can also be insertedthrough the throughbores 26 of the second plate 204 to couple the secondplate 204 to the anatomy.

The distal end 222 can be curved and shaped to conform to the distalhumerus H. The distal end 222 can include the leading portion 116 and acurved portion 224. The curved portion 224 can be shaped to correspondwith the lateral epicondyle 50 of the distal humerus H. The curvedportion 224 can include the bore 220.

With reference to FIGS. 6 and 7, the compression system 206 cancooperate with the first plate 202 and the second plate 204 to compressa distal humerus fracture. The compression system 206 can include afirst bone fastener or member 226 and a second bone fastener or member228. The first member 226 can have a head 230 and a shank 232. The head230 can be substantially spherical to mate with the bore 220. It shouldbe noted, however, that although the compression system 206 is describedand illustrated herein as being received through the bores 220, thecompression system 206 could also be received through any opposedthroughbores 26.

The head 230 can include a plurality of threads 230 a and a driverengagement feature 230 b. The plurality of threads 230 a can threadablyengage the plurality of threads 220 a of the bore 220 to fixedly couplethe first member 226 to the bore 220. The driver engagement feature 230b can receive a suitable instrument to drive the first member 226 intoengagement with the second member 228, as will be discussed herein. Theshank 232 can extend from the head 230. The shank 232 can include aplurality of threads 232 a at a distal end 232 b. The plurality ofthreads 232 a can threadably engage the second member 228.

With reference to FIG. 7, as the second member 228 can be similar to thefirst member 226, only the differences between the first member 226 andthe second member 228 will be discussed in great detail herein, and thesame reference numerals will be used to denote the same or similarcomponents. The second member 228 can include the head 230 and a shank234. The head 230 can be received in the bore 220 of the second plate204. The shank 234 can extend from the head 230. The shank 234 caninclude a cross bore 236. The cross bore 236 can be formed substantiallyperpendicular to a longitudinal axis L of the second member 228. Thecross bore 236 can include a plurality of threads 236 a. The pluralityof threads 236 a can threadably engage the plurality of threads 232 a ofthe first member 226 to threadably couple the first member 226 to thesecond member 228.

In order to couple the compressive plating system 200 to an anatomy,such as the distal humerus H, an incision can be made adjacent to thedistal humerus H. In one exemplary method, with reference to FIG. 6, thefirst plate 202 can be positioned adjacent to the distal humerus H, suchthat the curved portion 218 is adjacent to the medial epicondyle 38. Oneor more bone fasteners 152 can be inserted through the one or morethroughbores 26 of the first plate 202 to couple the first plate 202 tothe anatomy. The second plate 204 can be positioned about 90 degreesfrom the first plate 102 such that the curved portion 224 is adjacent tothe lateral epicondyle 50. One or more bone fasteners 152 can beinserted through the one or more throughbores 26 of the second plate 204to couple the second plate 204 to the anatomy.

In one example, the second member 228 can be inserted into the secondplate 204 such that the plurality of threads 230 a of the head 230threadably engage the plurality of threads 220 a of the bore 220. Then,a guide wire can be positioned between the bore 220 of the first plate202 and the cross bore 236 of the second member 228. Then, a drill bitcan be passed over the guide wire to form a bore B4 in the anatomy. Thefirst member 226 can be inserted into the bore 220 of the first plate202 so that the plurality of threads 230 a of the head 230 threadablyengage the plurality of threads 220 a of the bore 220 and the pluralityof threads 232 a of the shank 232 threadably engage the plurality ofthreads 236 a of the cross bore 236. The engagement between the firstmember 226 and the second member 228 can compress the fracture of thedistal humerus H.

With reference now to FIG. 8, in one example, a compressive platingsystem 250 can be employed to repair a damaged portion of an anatomy. Asthe compressive plating system 250 can be similar to the compressiveplating system 200 described with reference to FIGS. 6 and 7, only thedifferences between the compressive plating system 200 and thecompressive plating system 250 will be discussed in great detail herein,and the same reference numerals will be used to denote the same orsimilar components. With reference to FIG. 8, the compressive platingsystem 200 can include the first plate 202, a second plate 254 and thecompression system 260. In one example, the first plate 202 can bepositioned about 180 degrees apart from the second plate 254 about thedistal humerus H.

The second plate 254 can have a proximal end 258, the distal end 222,the first side 112 and the second side 114. The proximal end 258 canhave about the same length as the proximal end 108 of the first plate202. It should be noted that the proximal end 258 of the second plate254 could have a different length than the proximal end 108 of the firstplate 202, if desired.

With continued reference to FIG. 8, the compression system 260 cancooperate with the first plate 202 and the second plate 254 to compressa distal humerus fracture. The compression system 260 can include thefirst bone fastener or member 226 and a second bone fastener or member262. It should be noted, that although the compression system 260 isdescribed and illustrated herein as being received through the bores220, the compression system 260 could also be received through anyopposed throughbores 26.

The second member 262 can be similar to the first member 226, only thedifferences between the first member 226 and the second member 262 willbe discussed in great detail herein, and the same reference numeralswill be used to denote the same or similar components. The second member262 can include the head 230 and a shank 264. The shank 164 can extendfrom the head 230. The shank 264 can include a cross slot 266. The crossslot 266 is illustrated as being formed at an angle relative to thelongitudinal axis L of the second member 228, but could formedsubstantially perpendicular to a longitudinal axis L of the secondmember 228, if desired. Further, it should be noted that although thecross slot 266 is illustrated as comprising a slot, the cross slot 266could comprise a bore, if desired. The cross slot 266 can include aplurality of threads 266 a. The plurality of threads 266 a canthreadably engage the plurality of threads 232 a of the first member 226to threadably couple the first member 226 to the second member 262.

In this example, in order to compress a fracture, the second member 262can be inserted through the bore 220 of the second plate 254 such thatthe plurality of threads 230 a of the head 230 threadably engage theplurality of threads 220 a of the bore 220. Then, a guide wire can bepositioned between the bore 220 of the first plate 202 and the crossslot 266 of the second member 262. Then, a drill bit can be passed overthe guide wire to form a bore B5 in the anatomy. The first member 226can be inserted into the bore 220 of the first plate 202 so that theplurality of threads 230 a of the head 230 threadably engage theplurality of threads 220 a of the bore 220 and the plurality of threads232 a of the shank 232 threadably engage the plurality of threads 266 aof the cross slot 266. The engagement between the first member 226 andthe second member 262 can compress the fracture of the distal humerus H.Thus, the compression system 260 can be used to compress a fracture ofthe distal humerus H when the first plate 202 and the second plate 254are about 180 degrees offset from each other about the distal humerus H.

With reference now to FIG. 9, in one example, a compressive platingsystem 300 can be employed to repair a damaged portion of an anatomy. Asthe compressive plating system 300 can be similar to the compressiveplating system 250 described with reference to FIG. 8, only thedifferences between the compressive plating system 250 and thecompressive plating system 300 will be discussed in great detail herein,and the same reference numerals will be used to denote the same orsimilar components. With continued reference to FIG. 9, the compressiveplating system 300 can include the first plate 202, the second plate 254and a compression system 306. In one example, the first plate 202 can bepositioned about 180 degrees apart from the second plate 254 about thedistal humerus H. It should be noted that although not illustratedherein, the first plate 202 could be orientated about 90 degrees apartfrom the second plate 254 about the distal humerus H, and thecompression system 306 could be used to compress a fracture of thedistal humerus H.

The compression system 306 can cooperate with the first plate 202 andthe second plate 254 to compress a distal humerus fracture. Thecompression system 306 can include a first member 326 and a secondmember 328. The first member 326 and the second member 328 can bemagnetic, and in one example, can be composed of a biocompatible rareearth magnetic material so as to comprise permanent magnets. In oneexample, the first member 326 can comprise a north pole, while thesecond member 328 can comprise a south pole. The north pole of the firstmember 326 can be attracted to the south pole of the second member 328to compress the distal humerus H.

The first member 326 and the second member 328 can each have the head230 and a shank 332. The head 230 can be substantially spherical to matewith the bore 220. It should be noted, however, that although thecompression system 306 is described and illustrated herein as beingreceived through the bores 220, the compression system 306 could also bereceived through any opposed throughbores 26. The shank 332 can extendfrom the head 230. The shank 332 can include a plurality of threads 332a at a distal end 332 b. The plurality of threads 332 a can enable theadvancement of the first member 326 and the second member 328 throughthe anatomy.

In order to couple the compressive plating system 300 to an anatomy,such as the distal humerus H, an incision can be made adjacent to thedistal humerus H. In one exemplary method, the first plate 202 can bepositioned adjacent to the distal humerus H, such that the curvedportion 218 is adjacent to the medial epicondyle 38. As discussedpreviously, one or more bone fasteners can be inserted through the oneor more throughbores 26 of the first plate 202 to couple the first plate202 to the anatomy. The second plate 254 can be positioned about 180degrees from the first plate 202 such that the curved portion 224 isadjacent to the lateral epicondyle 50. One or more bone fasteners can beinserted through the one or more throughbores 26 of the second plate 254to couple the second plate 254 to the anatomy.

In one example, the first member 326 can be inserted into the secondplate 204 such that the plurality of threads 230 a of the head 230threadably engage the plurality of threads 220 a of the bore 220. Then,the second member 228 can be inserted into the second plate 204 suchthat the plurality of threads 230 a of the head 230 threadably engagethe plurality of threads 220 a of the bore 220. The attraction betweenthe north pole of the first member 326 and the south pole of the secondmember 328 can compress the fracture of the distal humerus H.

With reference now to FIGS. 10 and 11, in one example, a compressiveplating system 400 can be employed to repair a damaged portion of ananatomy. As the compressive plating system 400 can be similar to thecompressive plating system 100 described with reference to FIGS. 3 and4, only the differences between the compressive plating system 100 andthe compressive plating system 400 will be discussed in great detailherein, and the same reference numerals will be used to denote the sameor similar components. With reference to FIGS. 10 and 11, thecompressive plating system 400 can include a first plate 402, a secondplate 404 and a compression system 406. In one example, the first plate402 can be positioned opposite or about 180 degrees apart from thesecond plate 404 about the distal humerus H.

With reference to FIG. 10, the first plate 402 can have a proximal end408, a distal end 410, the first side 112 and the second side 114. Thefirst plate 402 can be composed of a suitable biocompatible material,such as a biocompatible metal or polymer. For example, the first plate402 could be composed of titanium or stainless steel. The first plate402 can include the plurality of throughbores 26, which can extendthrough the first side 112 and the second side 114 between the proximalend 408 and the distal end 410. The throughbores 26 can enable thereceipt of one or more fasteners, such as a bone fastener, to couple thefirst plate 402 to the anatomy.

The proximal end 408 of the first plate 402 can include a first bore 412and a second bore 414. Each of the first bore 412 and the second bore414 can be defined through the first plate 402 from the first side 112to the second side 114. One or more of the first bore 412 and the secondbore 414 can comprise slots, which can enable the compression system 406to be coupled to the anatomy at various orientations. Each of the firstbore 412 and the second bore 414 can comprise a plurality of teeth orpartial threads 412 a, 414 a, which can assist in fixedly coupling orlocking a portion of the compression system 406 to the first plate 402.Alternatively, the first bore 412 and the second bore 414 can comprise asmooth circular bore.

The distal end 410 can be curved and shaped to conform to the distalhumerus H. The distal end 410 can include the leading portion 116 and acurved portion 416. The curved portion 416 can be shaped to fit aroundthe lateral epicondyle 50 of the distal humerus H. The shape of thedistal end 410 can cooperate with the compression system 406 to enablethe first plate 402 to compress the distal humerus H. The curved portion416 can include a first compression bore 418. The first compression bore418 can receive a portion of the compression system 406 to assist incompressing a fracture of the distal humerus H. The first compressionbore 418 can include a plurality of threads 418 a, which can threadablyengage a portion of the compression device 406 to fixedly couple or lockthe portion of the compression device 406 to the first plate 402.

With continued reference to FIGS. 10 and 11, as the second plate 404 canbe similar to the first plate 402, only the differences between thefirst plate 402 and the second plate 404 will be discussed in greatdetail herein, and the same reference numerals will be used to denotethe same or similar components. The second plate 404 can have a proximalend 420, a distal end 422, the first side 112 and the second side 114.The second plate 404 can be composed of a suitable biocompatiblematerial, such as a biocompatible metal or polymer. For example, thesecond plate 404 could be composed of titanium or stainless steel. Thesecond plate 404 can include the plurality of throughbores 26, which canenable the receipt of one or more fasteners, such as a bone fastener, tocouple the second plate 404 to the anatomy.

The proximal end 420 of the second plate 404 can include a third bore424 and a fourth bore 426. Each of the third bore 424 and the fourthbore 426 can be defined through the second plate 404 from the first side112 to the second side 114. The third bore 424 can be annular orspherical, and can receive a portion of the compression system 406therethrough. The third bore 424 can include a plurality of threads 424a, which can fixedly couple a portion of the compression system 406 tothe third bore 424. The fourth bore 426 can comprise a slot, which canenable the compression system 406 to be coupled to the anatomy atvarious orientations. The fourth bore 426 can comprise a plurality ofteeth or partial threads 426 a, which can assist in fixedly coupling orlocking a portion of the compression system 406 to the second plate 404.Alternatively, the fourth bore 426 can comprise a smooth circular bore.

The distal end 422 can be curved and shaped to conform to the distalhumerus H. The distal end 422 can include the leading portion 116 and acurved portion 428. The curved portion 428 can be shaped to fit aroundthe medial epicondyle 38 of the distal humerus H. The shape of thedistal end 422 can cooperate with the compression system 406 to enablethe second plate 404 to compress the distal humerus H. The curvedportion 428 can include a second compression bore 430. The secondcompression bore 430 can receive a portion of the compression system 406to assist in compressing a fracture of the distal humerus H. The secondcompression bore 430 can include a plurality of threads 430 a, which canthreadably engage a portion of the compression device 406 to fixedlycouple or lock the portion of the compression device 406 to the secondplate 404.

With reference to FIGS. 10 and 11, the compression system 406 cancooperate with the first plate 402 and the second plate 404 to compressthe fracture of the distal humerus H. The compression system 406 caninclude a first bone fastener 432, a second bone fastener 434 and athird bone fastener 436. The first bone fastener 432 and the second bonefastener 434 can be longer than the third bone fastener 436 to span asubstantially diagonal distance between the first plate 402 and thesecond plate 404. Each of the first bone fastener 432 and the secondbone fastener 434 can include a head 438 and a shank 440. The head 438can include a plurality of threads 438 a, which can assist in couplingthe first bone fastener 432 and the second bone fastener 434 to arespective one of the first plate 402 and the second plate 404. Theshank 440 can be generally smooth, and can include a plurality ofthreads 440 a at a distalmost end 440 b. The plurality of threads 440 acan assist in coupling the first bone fastener 432 and the second bonefastener 434 to a respective one of the first plate 402 and second plate404.

In this regard, the first bone fastener 432 can be inserted through thefirst compression bore 418 of the first plate 402 to the fourth bore 426of the second plate 404. The plurality of threads 438 a of the head 438of the first bone fastener 432 can threadably engage the plurality ofthreads 418 a of the first compression bore 418, and the plurality ofthreads 440 a of the shank 440 can be threadably coupled to theplurality of partial threads 426 a of the fourth bore 426. The secondbone fastener 434 can be inserted through the second compression bore430 of the second plate 404 to the first bore 412 of the first plate402. The plurality of threads 438 a of the head 438 of the second bonefastener 434 can threadably engage the plurality of threads 430 a of thesecond compression bore 430, and the plurality of threads 440 a of theshank 440 can be threadably coupled to the plurality of partial threads412 a of the first bore 412.

The third bone fastener 436 can be smaller than the first bone fastener432 and the second bone fastener 434. The third bone fastener 436 caninclude a head 442 and a shank 444. The head 442 can include a pluralityof threads 442 a for fixedly coupling the third bone fastener 436 to thesecond plate 404. The head 442 can be generally spherical, but couldhave any suitable shape. The shank 444 can extend from the head 442. Theshank 444 can include a plurality of threads 444 a at a distalmost end444 b. The plurality of threads 444 a can assist in coupling the thirdbone fastener 436 to the first plate 402.

In this regard, the third bone fastener 436 can be inserted through thethird bore 424 of the second plate 404 to the second bore 414 of thefirst plate 402. The plurality of threads 442 a of the head 442 of thethird bone fastener 436 can threadably engage the plurality of threads424 a of the third bore 424, and the plurality of threads 444 a of theshank 444 can be threadably coupled to the plurality of partial threads414 a of the second bore 414.

In order to couple the compressive plating system 400 to an anatomy,such as the distal humerus H, an incision can be made adjacent to thedistal humerus H. In one exemplary method, with reference to FIG. 1, thefirst plate 402 can be positioned adjacent to the distal humerus, suchthat the curved portion 416 is adjacent to the lateral epicondyle 50.One or more bone fasteners can be inserted through the one or morethroughbores 26 of the first plate 402 to couple the first plate 402 tothe anatomy. The second plate 404 can be positioned opposite the firstplate 402 such that the curved portion 428 is adjacent to the medialepicondyle 38. One or more bone fasteners can be inserted through theone or more throughbores 26 of the second plate 404 to couple the secondplate 404 to the anatomy.

With or without the use of a guide wire, with reference to FIG. 11, afirst bore B5 can be formed through the distal humerus H from the firstcompression bore 418 of the first plate 402 to the fourth bore 426 ofthe second plate 404. Then, with or without the use of a guide wire, asecond bore B6 can be formed through the second compression bore 430 ofthe second plate 404 to the first bore 412 of the first plate 402. Withor without the use of a guide wire, a third bore B7 can be formedthrough the distal humerus H from the third bore 424 of the second plate404 to the second bore 414 of the first plate 402.

Next, in one exemplary method, the first bone fastener 432 can beinserted into the first bore B5 so that the plurality of threads 438 aof the head 438 can threadably engage the plurality of threads 418 a ofthe first compression bore 418, and the plurality of threads 440 a ofthe shank 440 can be threadably coupled to the plurality of partialthreads 426 a of the fourth bore 426. The second bone fastener 434 canbe inserted into the second bore B6 so that the plurality of threads 438a of the head 438 can threadably engage the plurality of threads 430 aof the second compression bore 430. The plurality of threads 440 a ofthe shank 440 can be threadably coupled to the plurality of partialthreads 412 a of the first bore 412. The third bone fastener 436 can beinserted into the third bore B7 so that the plurality of threads 442 aof the head 442 can threadably engage the plurality of threads 424 a ofthe third bore 424. The plurality of threads 444 a of the shank 444 canbe threadably coupled to the plurality of partial threads 414 a of thesecond bore 414. It should be noted that the first bore B5, second boreB6 and third bore B7 need not be formed through the anatomy prior toinsertion of the first bone fastener 432, second bone fastener 434 andthird bone fastener 436, but rather, the first bone fastener 432, secondbone fastener 434 and third bone fastener 436 could be driven throughthe anatomy to form the bores B5-B7.

The insertion and coupling of the first bone fastener 432, second bonefastener 434 and the third bone fastener 436 to the first plate 402 andthe second plate 404 can compress a fracture of the distal humerus H.The use of the first bone fastener 432, second bone fastener 434, thethird bone fastener 436, first plate 402 and second plate 404 canprovide support for two of the three sides of the distal humerus H forstability. The compression system 406 can create compression across thethird side of the distal humerus H to provide additional stability forthe distal humerus H.

Accordingly, the compression plating system 10, 100, 150, 200, 250, 300,400 can be used to repair damaged tissue in the anatomy, such asrepairing a fracture of the distal humerus H. The compression system 16,106, 206, 306, 406 can provide compression against the fracture, whichcan stimulate bone growth and healing. Thus, the use of the compressionplating system 10, 100, 150, 200, 250, 300, 400 can improve the recoverytime for a patient with a fracture of the distal humerus. In addition,as the compression system 16, 106, 206, 306, 406 can be used with firstplates 10, 102, 202, 404 and second plates 14, 104, 254, 406 that areabout 180 degrees apart about the distal humerus H and the compressionsystem 106, 206 can be used with first plates 102, 202 and second plates154, 204 that are about 90 degrees apart about the distal humerus H, thesurgeon can be provided with a variety of options to suit the needs ofvarious patients.

While specific examples have been described in the specification andillustrated in the drawings, it will be understood by those of ordinaryskill in the art that various changes can be made and equivalents can besubstituted for elements thereof without departing from the scope of thepresent teachings. Furthermore, the mixing and matching of features,elements and/or functions between various examples is expresslycontemplated herein so that one of ordinary skill in the art wouldappreciate from the present teachings that features, elements and/orfunctions of one example can be incorporated into another example asappropriate, unless described otherwise, above. Moreover, manymodifications can be made to adapt a particular situation or material tothe present teachings without departing from the essential scopethereof. Therefore, it is intended that the present teachings not belimited to the particular examples illustrated by the drawings anddescribed in the specification, but that the scope of the presentteachings will include any embodiments falling within the foregoingdescription.

What is claimed is:
 1. A system for compressing a fracture, the systemcomprising: a first bone plate having a first proximal end and a firstdistal end; a second bone plate having a second proximal end and asecond distal end; a compression system including a first member and asecond member; the first member coupled to one of the first bone plateand the second bone plate, the first member having a first shank with athreadless portion and having a threaded bore in the threadless portiontransverse to an axis of the first member such that the bore is formedsubstantially perpendicular to a longitudinal axis of the first member;and the second member coupled to the other of the first bone plate andthe second bone plate such that the second member passes through thebore of the first member, and is threadably coupled to the first membersubstantially perpendicularly to a longitudinal axis of the first shanksuch that movement of the first member relative to the second membercauses a compressive force to be applied between the first bone plateand the second bone plate.
 2. The system of claim 1, wherein the firstbone plate comprises a first bore at the first distal end that has afirst plurality of threads, and the second bone plate comprises a secondbore at the second distal end that includes a second plurality ofthreads.
 3. The system of claim 2, wherein the second member includes asecond head and a second shank, the second head having a third pluralityof threads and the second shank having a fourth plurality of threads,the third plurality of threads of the second head threadably engagablewith the second plurality of threads to couple the second member to thesecond bone plate.
 4. The system of claim 3, wherein the first memberincludes a first head, the first head having a fifth plurality ofthreads and the bore in the first shank defining a sixth plurality ofthreads, the fifth plurality of threads of the first head threadablyengagable with the first plurality of threads to couple the first memberto the first bone plate.
 5. The system of claim 4, wherein the fourthplurality of threads of the second shank are threadably couplable to thesixth plurality of threads of the cross bore to couple the first memberto the second member and compress the fracture.